Customized Reconstruction of Lower Eyelid Defects

Hyeokjae Kwon, Bokeun Song, Yooseok Ha, Sunje Kim, Sang-Ha Oh, Y. Seo, S. Song
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Abstract

Background: A lower eyelid defect is a loss of skin, muscle, and underlying structures that can occur due to trauma, malignant or benign tumors, burns, or other causes. The conventional surgical treatment of lower lid defects has several limitations, including visible scarring, narrowing of the eye, and ectropion. Here, we combined the use of a customized mid-face lift with a free mucochondral graft to overcome the disadvantages of existing methods. Methods: Forty patients underwent reconstructive surgery using a customized mid-face lift with or without a free mucochondral graft for a lower lid defect between April 2013 and October 2020. Patients were discharged shortly after surgery and were expected to visit the outpatient clinic periodically for 12 months. Results: The causes of lower eyelid defects were malignancy, trauma, foreign body granuloma, and other causes. Four patients reported complications, including 2 cases of chemosis, 1 case of a hematoma, and 1 case of corneal abrasion, who reportedly performed well after 2 weeks of conservative therapy. No patient required revision during the average follow-up period. Conclusions: Customized reconstruction demonstrated a better aesthetic reconstruction of the lower eyelid. This method represents a good option for reconstructing lower lid defects.
量身定制的下眼睑缺损再造手术
背景:下睑缺损是指皮肤、肌肉和下层结构的缺失,可由外伤、恶性或良性肿瘤、烧伤或其他原因引起。传统的下睑缺损手术治疗存在一些局限性,包括疤痕明显、眼球变窄和外翻。在此,我们将定制的面中部提升术与游离粘软骨移植相结合,以克服现有方法的缺点。手术方法在 2013 年 4 月至 2020 年 10 月期间,40 位患者接受了下睑缺损的整形手术,手术中使用了定制的中面部提升术,同时使用或不使用游离粘软骨移植。患者在术后不久出院,并在 12 个月内定期到门诊就诊。结果下睑缺损的原因包括恶性肿瘤、外伤、异物肉芽肿和其他原因。4名患者出现并发症,其中2例化脓,1例血肿,1例角膜擦伤,据报道,经过2周的保守治疗后,患者恢复良好。在平均随访期内,没有患者需要进行复查。结论定制化重建下眼睑具有更好的美学效果。这种方法是重建下睑缺损的良好选择。
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